Stroke care 'differences' revealed

A new report has highlighted differences in after-stroke care among poorer people

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Poorer people who suffer from strokes are more likely to receive a sub-standard level of care, a new study suggests.

Patients from more deprived areas are less likely to be admitted to hospital, less likely to be given a key test once in hospital and less likely to be given important post-stroke drugs, the research suggests.

Experts from King's College London and Guy's and Thomas' NHS Foundation Trust examined the stroke care and aftercare for 4,200 patients from south London between 1995 and 2010.

They found that patients from poor areas were a third less likely to be admitted to hospital than their richer neighbours.

The study, published in the Journal of Neurology, Neurosurgery and Psychiatry, also found that those in hospital were a third less likely to receive a swallow test. The NHS says that these tests are " essential" for anybody who has had a stroke because s wallowing problems affect over a third of patients.

Researchers also found that patients from deprived areas were half as likely to be taking drugs to lower their blood cholesterol three months after their stroke

The authors said that despite improvements to equal access to healthcare since 2001, stroke care remains "uneven" across Britain .

"Our study has highlighted a number of problems which remain in the provision of stroke care, and which explain the higher mortality rates seen in stroke patients from deprived areas," said Professor Charles Wolfe, professor of public health at King's College London and director of research and development at Guy's & St Thomas'.

"Our findings should help policy makers to introduce the measures needed to reduce health care inequalities and improve the prognosis of stroke."

Dr Ruoling Chen, senior lecturer in public health at King's College London, added: "The good news is that changes in health policies, the organisation of stroke services and advances in clinical practices have brought some improvements in the provision of care for stroke patients since 2001.

"These increased efforts in the UK to improve the quality of stroke care are showing encouraging results. However, we need to address ongoing problems with follow-up care in the community, such as ensuring all stroke patients receive the necessary medication."

Every year in England over 150,000 people have a stroke and it is the third largest cause of death, after heart disease and cancer.

"We know from existing research that people from economically deprived areas are twice as likely to have a stroke and more likely to die. Black people are twice as likely to have a stroke than white people.

"These findings should serve as a wake-up call to the Government and health services across the UK. While the reorganisation of stroke services and new scientific evidence have seen significant improvements in stroke treatments, there remain alarming differences in prevention, treatment and long-term care for people in deprived areas.

"We want to see an end to this discrimination, so that people have an equal chance in getting underlying conditions that lead to stroke identified and those who have a stroke get the immediate treatment, long-term care and support to make their best possible recovery.

"We are calling on those organising and providing health and care to tackle inequalities in stroke care provision so that we can drive down the numbers of strokes in deprived areas and ensure all stroke patients receive the best treatment possible."

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